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Infections After Liver Transplantation: A Retrospective, Single-Center Study

机译:肝移植术后感染:回顾性单中心研究

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摘要

Objective. To access the incidence of infectious problems after liver transplantation (LT).Design. A retrospective, single-center study.Materials and Methods. Patients undergoing LT from January 2008 to December 2011were considered. Exclusion criterion was death occurring in the first 48 hours after LT. We determined the site of infection and the bacterial isolates and collected and compared recipient’s variables, graft variables, surgical data, post-LT clinical data.Results. Of the 492 patients who underwent LT and the 463 considered for this study,190 (Group 1, 41%) developed at least 1 infection, with 298 infections detected. Of these, 189 microorganisms were isolated, 81 (51%) gram-positive bacteria (most frequently Staphylococcus spp). Biliary infections were more frequent (mean time of 160.4 167.7 days after LT); from 3 months after LT, gram-negative bacteria were observed (57%).Patients with infections after LT presented lower aminotransferase levels, but higher requirements in blood transfusions, intraoperative vasopressors, hemodialysis, and hospital stay. Operative and cold ischemia times were similar.Conclusion. We found a 41% incidence of all infections in a 2-year follow-up after LT. Gram-positive bacteria were more frequent isolated; however, negative bacteria were commonly isolated later. Clinical data after LT were more relevant for the development of infections. Donors’ variables should be considered in future analyses.
机译:目的。访问肝移植(LT)后感染问题的发生率。设计。回顾性单中心研究。材料与方法。考虑从2008年1月至2011年12月接受LT的患者。排除标准是在LT后的前48小时内发生死亡。我们确定了感染部位和细菌分离株,并收集并比较了接受者的变量,移植物变量,手术数据,LT后临床数据。结果。在492名接受LT的患者中,有463名接受本研究的患者,其中190名(第1组,占41%)发生了至少1次感染,检测到298次感染。其中,分离出189种微生物,其中81种(51%)革兰氏阳性细菌(最常为葡萄球菌属)。胆道感染更为频繁(LT后平均时间160.4 167.7天);从LT术后3个月起,观察到革兰氏阴性细菌(57%)。LT术后感染的患者转氨酶水平较低,但输血,术中血管加压药,血液透析和住院时间的要求较高。手术和冷缺血时间相似。在LT的2年随访中,我们发现所有感染的发生率均为41%。革兰氏阳性细菌分离的频率更高。但是,阴性细菌通常在以后被分离出来。 LT后的临床数据与感染的发展更为相关。将来的分析中应考虑捐赠者的变量。

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